Lean PCOS causes challenges getting pregnant for Baton Rouge couple

Sally has never had a regular cycle. Her periods have always been irregular, two or three months apart. Over the years, she never really thought much about it or whether her irregularity had any implications for her fertility. That is, not until she and her husband Jim started trying to have a family. Then it all started to make sense.

Sally and Jim have been together for 12 years after meeting as swim coaches for a local Baton Rouge swim team. Over the years, their swim coaching jobs provided them the opportunity to mold young kids. Teaching kids to swim, coaching them to be competitive, and mentoring them into young adults has been a constant way of life for over a decade. Sally is also a middle school science teacher, so the idea that they, too, wanted to be parents one day has always been in the back of their minds. “Kids have just always been a part of our lives,” says Sally.

After marrying two years ago, Sally and Jim, a musician who plays in a local cover band, finally felt ready to start a family together. But after a year and a half trying, Sally knew she needed to get some help. She started by working with her OB/Gyn through a few medicated cycles with clomid and letrozole. Blood work and testing, however, showed that Sally wasn’t ovulating. Her doctor then referred her to Dr. Neil Chappell at Fertility Answers in Baton Rouge.

Cycle irregularity often indicates the ovaries are not working properly

Irregular cycles most often indicate a problem with ovulation or other conditions that can lead to infertility. Generally, your cycle is considered “regular” if it occurs about every 28 days. This reflects a normal hormone cycle and the hormonal changes that occur each month as the body prepares to release an egg from the ovary. This hormone cycle is also responsible for making the uterine lining receptive to receive a fertilized egg.

Cycle irregularity is considered a red flag for fertility and can be caused by many different reasons. After extensive testing, Dr. Chappell figured out Sally’s irregularity is mainly the result of lean PCOS (now called PMOS), a complex endocrine, metabolic and reproductive syndrome that causes the body’s hormones to be out of balance. The endocrine system is what signals the organs to work the way they should. For Sally, this meant her lean PCOS was making the brain not signal her ovaries to work correctly resulting in her irregular periods and not being able to mature and ovulate eggs. 

Over four months as patients of Fertility Answers, Sally and Jim tried monthly intrauterine insemination cycles, each either negative or having to be canceled due to high over-response to ovulation medications. “We did a good job of staying positive, but of course it was disappointing,” says Sally. “But every failed attempt, we’ve learned something new, so we knew we just had to nail down what was going on. We felt like we were making progress even with disappointing results.”

In vitro fertilization was their next step

Dr. Chappell recommended the couple consider in vitro fertilization as a better option in their case, since Sally was over-responding to the medication and producing too many egg follicles. When this happens in an IUI cycle, it results in the cycle being canceled. But producing many egg follicles during an IVF cycle is actually a good thing since that is the point of the ovarian stimulation phase of this treatment option.

IVF, however, is much more costly than IUI and the couple worried about being able to fit this into their budget. “I told the nurses after Dr. Chappell told our options that our finances probably wouldn’t allow us to pursue IVF,” remembers Sally. “But they suggested submitting an application to the Gift of Hope Grant, actually due the next day. I have to think it was a sign that we were made aware of this grant the day before.”

Upon learning they had won the Gift of Hope IVF Grant, Sally and Jim are so grateful for this opportunity. “We’ve worried that all this difficulty was a sign that we just weren’t meant to have kids. Receiving the grant reassured us that we are on the right track, and that this is meant to be.”